The overall goal of this two-year research study is to develop a comprehensive and effective multisystem measurement model to understand the underlying causes of the social determinants of health (SDH) and their relation to health disparities. Specific aims: 1) Establish a diverse coalition of policy makers, community members, and representatives and stakeholders from multiple systems and sectors-economic development, business, education, labor, housing, transportation, environment, agriculture, and healthcare-as well as academic investigators from disciplines such as clinical and social sciences, health services, law, education, engineering, business and economics, and anthropology;2) As a coalition, define measures, identify gaps, and develop measurement methods to assess health inequities, health outcomes, SDH, and the consequences of poor health;3) Create working groups to implement the measurement model developed in Aim 2 in urban city (Birmingham) and rural town (Selma);4) Analyze and interpret the findings of the working groups in the context of one combined data system to identify relationships and pathways of SDH as they relate to health disparities. 5) Based on the analyses in Aim 4, develop recommendations for new research questions, education and training programs, and policy changes to address the SDH and reduce health inequities. Design and Methods: The development, implementation, and evaluation will be rooted in and guided by the social ecological model, the community-based participatory approach (CBPA), and the empowerment theory. We have assembled a coalition that includes investigators from the fields of medicine, public health, sociology, psychology, anthropology, law, engineering, nursing, and education, as well as organizations, community experts, and local and state officials representing the areas of urban planning, economic development, agriculture, education, banking, transportation, law, and faith-based organizations. The project will target urban and rural environments (represented by the city of Birmingham and the town of Selma, Alabama). Both locales have a high proportion of low-income African Americans (70%) who suffer from higher mortality and morbidity rates of major health conditions. Significance: By using the above multisystem, trans-disciplinary approach, the project will identify in-depth patterns and pathways, which will enable us to understand the underlying causes of the SDH and their interaction. Study results will help develop a set of recommendations and a sustainable action plan to reduce the inequities. These recommendations and action plan will generate further research to develop and disseminate evidence-based interventions;they will also necessitate education and training in order to improve the health-care delivery;and inform policy and stimulate political action, which will impact public health. The overall goal of the proposed research study, GO-ing Forward, is to develop a comprehensive and effective multisystem measurement model to understand the underlying causes of the social determinants of health (SDH) and their relation to health disparities. Such model will allow for systematic analysis of the health impact of SDH and will help develop recommendations to reduce the inequities. These recommendations will 1) generate further research to develop and disseminate evidence-based interventions, 2) necessitate education and training to improve health-care delivery, 3) and inform policy and stimulate political action, which will impact public health. 1